 Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 7:01pm On Jul 31, 2019 |
Doctoropera:
He doesn't need an invitation letter? No, invitation is not needed. It's only in formal situations such as business conferences, scientific symposia, etc that invitation would be needed. |
| Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 10:52pm On Jul 30, 2019*. Modified: 12:43am On Jul 31, 2019 |
achu442:
Hello, someone put me through... My online date needs to send me an invitation to USA, What are the documents she needs to do this? You'll need documents that will prove you have sufficient ties to Nigeria. You need to prove to them that you won't abscond. Ties include, but is not limited to, the following: marriage, kids, old age, long term employment, reasonable salary, good bank account statement, good travel history, etc. Any document that can prove the above in addition to other things should be made ready. In addition to the above, you'll need to fill the form D-160 form, pay the visa fee at GTBank, and schedule an appointment with ustraveldocs. For more info, check out page one of this thread. You don't need invitation letter. |
| Politics › Re: Senate Confirms Buhari’s 43 Ministerial Nominees (Full List) by Obinoscopy(m): 2:42pm On Jul 30, 2019 |
7 women out of 43. That's 16%. Well, it can get better with time. |
| Politics › Re: Supreme Court Sacks Mustapha Usman As Lawmaker. "Forged Credentials & NYSC" by Obinoscopy(m): 1:53pm On Jul 30, 2019 |
saintchibu:
That is not the ruling of the Supreme Court.
Do not mind all these quack bloggers.
Here is the decision of the Apex Court
"A five-man panel of the court, in a unanimous judgment on Tuesday, upheld an appeal marked: SC/790/2019 from Abdulra’uf Abdulkadir Modibo also of the APC.
The apex court held that aside that Usman forged his credentials, he also did not participate in the National Youth Service Corps scheme.
The five-man panel of the court, led by Justice John Okoro, also ruled that Modibo, who came second in the APC primary, should be issued certificate of return by the Independent National Electoral Commission (INEC)."
Check Daily Post for details. Its actually conflicting. The Nation, The Guardian and The Daily Post all gave conflicting verdicts. |
| Politics › Re: Supreme Court Sacks Mustapha Usman As Lawmaker. "Forged Credentials & NYSC" by Obinoscopy(m): 1:45pm On Jul 30, 2019 |
onamch:
Ngeneukwenu, the supreme court has spoken. A PDP man comes up. Not true. An APC aspirant/candidate who fully participated in the primaries (other than Modibbo) gets it. |
| Christianity Etc › Re: Have You Praised Him Yet, Today? by Obinoscopy(m): 1:35pm On Jul 28, 2019 |
Father, You are awesome. Thank You for the gift of Life. Thank You for the things You've done for me and my famulh in the past. Thank You for the things You'll do in the future. You are an awesome God. |
| Travel › Re: USA Fiancee (K1) Visa Thread by Obinoscopy(m): 2:13pm On Jul 22, 2019 |
That's sad. That's greed. That's selfishness. |
| Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 2:43am On Jul 18, 2019 |
123JohnF:
He-he-he, are you sure? Yes I am 100%. I have friends who work with the Department of Homeland Security. One thing I notice about them is their humility. And you lack that virtue. I even doubt if you have complete papers in the States. |
| Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 1:33am On Jul 18, 2019 |
123JohnF:
What should be and how it's done, denied or not and if CO just took the decision to deny before the interview IT IS NOT YOUR BUSINESS. Go and tell you wife what should be or not. CO has the decision and if he/she didn't sleep well or tired, he/she denies because he has this POWER. And NO foreigners's opinion how to do our law and how to manages our visas. Go and give your order in your kitchen. 
Who cares what you want in our embassy? Apply, pay, wait in line and be polite and we will see if we want to open our house door for you. Keep saying our COs should do this or shouldn't do that, you will be denied just for talking crap and being a trouble maker. Enjoy. A simple question you cannot answer. I rest my case. Thank God you are not a consular officer. |
| Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 8:46pm On Jul 17, 2019*. Modified: 9:27pm On Jul 17, 2019 |
123JohnF:
Lol, apply for a tourist visa and see 90% rejected if they have family, friends, fiance(e) in US. All CO sees is you have somebody in US to help you to stay and overstay and maybe to fix your status being already there. Go and try. All I say how our embassy works.
Do you wanna meet your BF or GF, go to Nigeria and meet there or Barbados, etc. as many Nigerians do.
But you are welcome to apply and to waste your money in our embassy. Thank you very much for attacking me. I see you are now changing the premise of your argument. We all knew before now that having a relative in the States is a minus in B1/B2 visa application just as we know that being single is also a minus. But if the applicant can adequately prove that he or she has sufficient ties to Nigeria, (s)he will be granted the visa regardless of whether he or she is single or has a fiancee in the States. Having a fiancee in the States shouldn't be an automatic denial. Thats my argument. I'm also of the view that telling all B2 applicants who has a USC fiancee that he or she should rather apply for K1 visa is very wrong. This may not apply in some cases. Now let me paint a scenario and seek your advice. Imagine a well travelled guy who has been to the States on vacation several times and for business over the past 5 years. In his penultimate visit, he happened to meet this very beautiful girl with whom he started off a relationship with and proposed in his last visit to the States. Now his visa is expired and he wants to renew so that he can visit his heartthrob and He intends telling the VO the truth when he goes for his visa interview. They don't plan to get married yet. Do you recommend he be granted the B1/B2 visa? |
| Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 5:12pm On Jul 17, 2019 |
NothingDoMe:
That was a case specific scenario. It was an option given to her because of limited B1/B2 issuance. The officer was being helpful. I really hope it was case specific. It will be sad if every applicant who has a USC fiance is denied a B2 visa. |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 4:24pm On Jul 17, 2019 |
Liverpoolfc:
Even normotensive diabetic patients are given low dose ACE inhibitor. Really? Wow, didn't know that. |
| Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 1:58pm On Jul 17, 2019 |
seyewest:
True and that was an oversight but most time they advise most applicant to apply for K1 visa. Yeah, and that is wrong in my opinion. Very soon they will also be advising B2 applicant whose parents or siblings are based in the US to apply for F2 Visa. |
| Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 1:48pm On Jul 17, 2019 |
seyewest:
Calling someone Fiance is different from boyfriend and girlfriend A Fiance is a relative going by US Embassy definition. It's different from boyfriend and girlfriend I agree. It's in the same category as parents and siblings. I've seen people whose siblings and/or parents are USC and yet got their B1/B2 visa approved. Same should be for Fiance. most time the partner living in U.S will visit Nigeria and do traditional/court wedding in Nigeria before applying for K1 visa. I don't understand your point here. And by the way, anyone who does traditional or court wedding in Nigeria isn't eligible for K1 Visa. He or she should rather apply for Spousal Visa (CR1) |
| Christianity Etc › Re: Have You Praised Him Yet, Today? by Obinoscopy(m): 1:28pm On Jul 17, 2019 |
Thank you Lord for the gift of Life. |
| Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 12:53pm On Jul 17, 2019*. Modified: 1:16pm On Jul 17, 2019 |
TWoods:
He is free to find someone else to date from his own country where a visa will not be an issue. He cannot expect to use a visit visa to "date". That's not what it was meant for. If their relationship is serious then they should get a K1 visa, if not, let them find other people to date. Don't be so hard on yourself and other Nigerians seeking visit visa. Visit visa can be used to go visit one's fiance as long as he or she intends to return to Nigeria after the visit. Below are things that can be done on a visit visa: a. Tourism
b. Vacation (holiday)
c. Visit with friends or relatives
d. Medical treatment
e. Participation in social events hosted by fraternal, social, or service organizations
f. Participation by amateurs in musical, sports, or similar events or contests, if not being paid for participating
g. Enrollment in a short recreational course of study, not for credit toward a degree (for example, a two-day cooking class while on vacation) https://travel.state.gov/content/travel/en/us-visas/tourism-visit/visitor.htmlOption a, b, c and e are activities that are done during "dating". So I wonder why you say two people who are in love can't "date" in the US. I believe they can "date" as long as the Nigerian can prove that (s)he has no immigration intent. It's the same kind of proof that someone whose relative (mum, dad, siblings, etc) is based in the US is required to provide in his/her visit visa application. Nothing different. cc: 123JohnF |
| Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 3:07am On Jul 17, 2019 |
123JohnF:
If they wish to date longer, CO will tell them to see each other in another country or the America citizen moving to live abroad for to be close to his/her date. It is not obligatory to date on US territory. The couple is free to date, so many countries with no visa problem, to live together for years, marry when you want Well that's an option for them. But K1 visa isn't an option for them since they are still dating. nobody is forcing you to marry. K1 visa is not forcing, it is the visa for people who already decided to marry and to live in America. Also, you can come on K1 visa, stay 90 days and not marry, going back to your country.
Who is forcing you to marry? For the VO to deny the visit visa and suggest K1 visa he is "forcing" them to marry. He shouldn't have suggested K1 visa to him or her. And to the bolded, its not okay to use the K1 visa with the intent of staying in the US for 90 days without getting married and then return back to Nigeria. That will be seen an abuse of the K1 visa and could affect his chances of ever getting any other visa in the States. |
| Travel › Re: USA Visit Visa Part 4 by Obinoscopy(m): 12:26am On Jul 17, 2019 |
TWoods:
The consular officer was being helpful. If you intend to marry the guy then get a K1 visa, it’s much easier and entitles you to stay in the US for 3 months to get married. That's not fair because the K1 visa forces them to get married within 3 months. Some people date for years before getting married. K1 visa won't be ideal for such people as it will not allow them date for years. The ideal visa for them will be the visit visa until such a time they are ready to take the next step which will then involve getting the K1 Visa. |
| Travel › Re: Canadian Express Entry/federal Skilled Workers Program - Connect Here Part 8 by Obinoscopy(m): 3:12pm On Jul 15, 2019 |
damzy88:
Transcript didn't take more than 1 month. It was the WES stuff that took longer (3 months). Thanks for your response. I sent you a PM. Please check your mail. |
| Travel › Re: Canadian Express Entry/federal Skilled Workers Program - Connect Here Part 8 by Obinoscopy(m): 12:30am On Jul 14, 2019 |
@damzy88, please how long did it take you to get your unilag transcript? |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 11:18pm On Jul 13, 2019*. Modified: 11:14pm On Sep 02, 2019 |
Blessgod30:
Interested in being a member of this forum
Pharmacist jerryvyne:
Interested
A pharmacy student vicmed1:
I am interested.
400 level medical student Thewhizzkid1:
I am interested.
I'm a medical student. You are hereby inducted to this honorable thread. Welcome. The medical community are most honored to have you. See updated list: https://www.nairaland.com/5289692/clinical-pharmacology-discussion-thread#80073865CLINICAL PHARMACOLOGY DISCUSSION THREAD MEMBERS
Obinoscopy - Pharmacist/Epidemiologist
Charliejose - Pharmacology Student
Aysuccess99 - Medical Student Aspirant
Brini - Medical Student
Zenti99 - Medical Student Aspirant
Damitism - Pharmacy Student
Teecube - Pharmacy Student
Eloghosa78 - Medical Student Aspirant
Passion007 - Medical Doctor
Samgreguc - Pharmacy Student
Eyideejay - Medical Student
ULQUIORRA - MSc Pharmacology Student
Tolugar - Physiologist/Pharmacologist
Fostermd - Medical Doctor (Psychiatrist/Neuropsychopharmacologist)
Ajpharm - Pharmacy Student
Thefarr - Veterinary Doctor
Captainnigeria - Pharmacy Student Aspirant
Gbosaa - Herbalist
Adaminedens - Medical Doctor
YMCgyna - Pharmacy Student
DrClay - Medical Doctor
Breezy90 - Pharmacy Student
Edyza - Anatomist/MSc Clinical Pharmacology Student
Lebienconnu - Medical Student
Kunlexic - Pharmacy Student Aspirant
Arsenate - Pharmacist/MSc Pharmacology Student Aspirant
Razzydoo - MSc Pharmacology (in view)
Usen9c - Chemist
Sakaguchi - Medical Student
Itzpretzy - Pharmacy Student
Hustla242 - Clinical Pharmacologist
Dungdusugyang - Medical Biochemist
GogetterMD - Medical Doctor
Quatermaine - Medical Student
Cnwamo - Nurse/Medical Student
Imperiouxx - Biochemist
Hensben - Pharmacologist
Frankyskyboi - Pharmacist
Ochek - Nurse
DonJ2 - Medical Lab Scientist
Aieromon - Pharmacist
JoannaSedley - Nurse/Anaesthetician/Doctor of Nursing (In View)
Swashi007 - Pharmacy Student
Debuscket - Radiographer
Johnsonpac - Biochemist
Tekel - Human Anatomist
JellyBean190 - Medical Doctor
Nnewi1stSon - Pharmacist
DebhariJones - Interim Pharmacist
ADUBA1 - Health and Environment
Babymillenium - Nurse
Philtrum - Medical Student
Liverpoolfc - Human physiologist
Xkid2000 - Pharmacist student
Drfash - Medical Student
Tebill - Biochemist/Medical doctor
Deltaboy10 - Medical Student
Tydd - Interim Pharmacist
Godwinigweh - Nursing Student
Yahbas83 - Medical Student
Waloma - Nurse
Mbatagr82 - Medical lab Science Student
Xoctic - Medical Student
Winzor78 - Medical Student
Igwedexy - Physiology
Lexo22 - Biochemist
Leward - Medical Student
FutureDon - Neuroscientist
Shollyps - Biochemistry Student
Firstolalekan - MSc Clinical Pharmacology Aspirant
Rxfemi - Pharmacist
Godfreykingsley - Anatomist
Greenslicks - Counselling Psychologist
Adeoladrg - Pharmacy Student
Kennymighty - Clinical Biochemist
Anselm791 - Medical Student
Johncuppa - Chemist/Pharmacy Student Aspirant
Mzdharmey - Pharmacology Student
Kinxlink - Pharmacology Aspirant
Mesther96 - Pharmacology Student
Winbyforce - Physician/Pharmacologist
Crispinkc - Dental Student
Armani03 - Medical biochemist Student
Man100 - Microbiologist
Tygood - Physiology Student
Bioduneberry - Chemist
CircleOfWilis - Medical doctor
Ekpekus - Medical doctor/Msc. Pharmacology
AGgal - Nurse/Midwife
Baebyfaze91 - Pharmacist student
Linguist - Nurse (accident& emergency)
Tfun - Nursing Student
DrAmanda - Medical Student
Somtea - Pharmacist
Abdulsalax - Pharmacist Aspirant
ProfEinstein - Physiotherapist
Mashad - Anatomist
Amaham - Anaesthesiologist
Kenshin17 - Biochemistry
Kristana - Pharmacist Student
1k001 - General Physician
Biolaolowo - Medical Student
Delpharm - Pharmacist Student
Desy24444 - Nurse
Tycoon4 - Intern. Pharmacist
Dynasty92 - Pharmacist Student
Tushqueen - Radiographer
Cmanforall - Clinical Pharmacologist Aspirant
Sisiafrika - Pharmacy Student
Akkylod - Medical Student
Tieeeboy - Human Anatomy Student
Tosodus - Medical Lab Tech/Biochemist/Medical Student Aspirant
Boluzie - Medical Student
Guldberg - Dental Surgery Student
Dadinho - MSc Pharmacology Aspirant
Shazily012 - Physiologist
Cxp - Medical Student
shollish - Pharmacy Student
Blessgod30 - Pharmacist
Jerryvyne - Pharmacy Student
Vicmed1 - Medical Student
Thewhizzkid1 - Medical Student |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 10:49pm On Jul 13, 2019*. Modified: 12:52pm On Jul 15, 2019 |
Aaronzy:
Clinicians in the house
Why is it not advisable to give beta blocker to a hypertensive patient who is as well diabetic? This is because beta blockers are known to reduce insulin secretion at the pancreas and decrease insulin sensitivity. The beta-2 adrenergic receptors is known to play a role in insulin release thus any beta blocker that has some affinity for beta-2 receptor can worsen diabetic treatment. Its interesting to note that alpha adrenergic receptors does the opposite. Reference:Das, V.A., Robinson, R. & Paulose, C.S. Enhanced β-adrenergic receptors in the brain and pancreas during pancreatic regeneration in weanling rats. Mol Cell Biochem (2006) 289: 11. https://doi.org/10.1007/s11010-006-9142-6 |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 7:07pm On Jul 12, 2019*. Modified: 11:09pm On Sep 02, 2019 |
shollish:
Interested
Final year pharmacy student You've been inducted as a member of this honorable thread. Welcome. CLINICAL PHARMACOLOGY DISCUSSION THREAD MEMBERS
Obinoscopy - Pharmacist/Epidemiologist
Charliejose - Pharmacology Student
Aysuccess99 - Medical Student Aspirant
Brini - Medical Student
Zenti99 - Medical Student Aspirant
Damitism - Pharmacy Student
Teecube - Pharmacy Student
Eloghosa78 - Medical Student Aspirant
Passion007 - Medical Doctor
Samgreguc - Pharmacy Student
Eyideejay - Medical Student
ULQUIORRA - MSc Pharmacology Student
Tolugar - Physiologist/Pharmacologist
Fostermd - Medical Doctor (Psychiatrist/Neuropsychopharmacologist)
Ajpharm - Pharmacy Student
Thefarr - Veterinary Doctor
Captainnigeria - Pharmacy Student Aspirant
Gbosaa - Herbalist
Adaminedens - Medical Doctor
YMCgyna - Pharmacy Student
DrClay - Medical Doctor
Breezy90 - Pharmacy Student
Edyza - Anatomist/MSc Clinical Pharmacology Student
Lebienconnu - Medical Student
Kunlexic - Pharmacy Student Aspirant
Arsenate - Pharmacist/MSc Pharmacology Student Aspirant
Razzydoo - MSc Pharmacology (in view)
Usen9c - Chemist
Sakaguchi - Medical Student
Itzpretzy - Pharmacy Student
Hustla242 - Clinical Pharmacologist
Dungdusugyang - Medical Biochemist
GogetterMD - Medical Doctor
Quatermaine - Medical Student
Cnwamo - Nurse/Medical Student
Imperiouxx - Biochemist
Hensben - Pharmacologist
Frankyskyboi - Pharmacist
Ochek - Nurse
DonJ2 - Medical Lab Scientist
Aieromon - Pharmacist
JoannaSedley - Nurse/Anaesthetician/Doctor of Nursing (In View)
Swashi007 - Pharmacy Student
Debuscket - Radiographer
Johnsonpac - Biochemist
Tekel - Human Anatomist
JellyBean190 - Medical Doctor
Nnewi1stSon - Pharmacist
DebhariJones - Interim Pharmacist
ADUBA1 - Health and Environment
Babymillenium - Nurse
Philtrum - Medical Student
Liverpoolfc - Human physiologist
Xkid2000 - Pharmacist student
Drfash - Medical Student
Tebill - Biochemist/Medical doctor
Deltaboy10 - Medical Student
Tydd - Interim Pharmacist
Godwinigweh - Nursing Student
Yahbas83 - Medical Student
Waloma - Nurse
Mbatagr82 - Medical lab Science Student
Xoctic - Medical Student
Winzor78 - Medical Student
Igwedexy - Physiology
Lexo22 - Biochemist
Leward - Medical Student
FutureDon - Neuroscientist
Shollyps - Biochemistry Student
Firstolalekan - MSc Clinical Pharmacology Aspirant
Rxfemi - Pharmacist
Godfreykingsley - Anatomist
Greenslicks - Counselling Psychologist
Adeoladrg - Pharmacy Student
Kennymighty - Clinical Biochemist
Anselm791 - Medical Student
Johncuppa - Chemist/Pharmacy Student Aspirant
Mzdharmey - Pharmacology Student
Kinxlink - Pharmacology Aspirant
Mesther96 - Pharmacology Student
Winbyforce - Physician/Pharmacologist
Crispinkc - Dental Student
Armani03 - Medical biochemist Student
Man100 - Microbiologist
Tygood - Physiology Student
Bioduneberry - Chemist
CircleOfWilis - Medical doctor
Ekpekus - Medical doctor/Msc. Pharmacology
AGgal - Nurse/Midwife
Baebyfaze91 - Pharmacist student
Linguist - Nurse (accident& emergency)
Tfun - Nursing Student
DrAmanda - Medical Student
Somtea - Pharmacist
Abdulsalax - Pharmacist Aspirant
ProfEinstein - Physiotherapist
Mashad - Anatomist
Amaham - Anaesthesiologist
Kenshin17 - Biochemistry
Kristana - Pharmacist Student
1k001 - General Physician
Biolaolowo - Medical Student
Delpharm - Pharmacist Student
Desy24444 - Nurse
Tycoon4 - Intern. Pharmacist
Dynasty92 - Pharmacist Student
Tushqueen - Radiographer
Cmanforall - Clinical Pharmacologist Aspirant
Sisiafrika - Pharmacy Student
Akkylod - Medical Student
Tieeeboy - Human Anatomy Student
Tosodus - Medical Lab Tech/Biochemist/Medical Student Aspirant
Boluzie - Medical Student
Guldberg - Dental Surgery Student
Dadinho - MSc Pharmacology Aspirant
Shazily012 - Physiologist
Cxp - Medical Student
shollish - Pharmacy Student https://www.nairaland.com/5289692/clinical-pharmacology-discussion-thread#80073865I will post the previously inducted members here soon. This post will be updated to include members who are newly inducted. |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 7:05pm On Jul 12, 2019 |
This thread is for all who are interested in the course Clinical Pharmacology. This include: Medical Doctors, Pharmacists, Nurses and medical students, pharmaceutical students, etc.
I've searched the whole of nairaland to see where Clinical Pharmacology topics are being discussed but couldn't find any. Thus I felt its necessary that this thread be created so that we can improve on our understanding of the course.
This is my plan:
* Each week, a new topic is scheduled for discussion
* A nairalander will give a brief presentation of the new topic on a Monday
* After each presentation, there will be questions, answers, comments, observations and suggestions from fellow nairalanders
* Only nairalanders who have been inducted into this Discussion Thread can be called on to give presentations however anyone can ask questions, comments, observations or suggestions
* Nairalanders are inducted into this Discussion Thread by simply indicating interest and by stating his profession. For example: "I am interested. I'm a pharmacist" OR "I'm interested. I'm a medical student"
* A space will be reserved for the list of inducted nairalanders
* A space will also be reserved for the list of topics to be discussed upon for the month/year
* The thread shall have a coordinator and an assistant coordinator. Also a moderator's blessing would be needed
* This plan may be modified upon by inducted members if 2/3 of the house agrees with the modification. https://www.nairaland.com/5289692/clinical-pharmacology-discussion-thread#80073592Fellow medical professionals, this thread is for discussions on pharmacology. Let's make it active! |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 6:29pm On Jul 09, 2019 |
Obinoscopy:
Hi guys, I had created the above thread in 2014 with the hope of steering up intellectual discuss among medical students and medical professionals. Unfortunately the thread disappeared so I had to create a new one.
Fortunately I was able to see some snapshots of the previous thread courtesy of web.archive.org. So I will post some of the snapshots here and hope that we continue from there.
Below is the original post that I made in the previous thread:
https://www.nairaland.com/1591582/clinical-pharmacology-discussion-thread Ok guys, let the discuss begin  |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 7:47am On Jul 09, 2019 |
Liverpoolfc: @Obinoscopy
that is simple,inhibition of parasympathetic supply dilate the blood vessel bt causes a reflex tarchycardia. |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 7:45am On Jul 09, 2019 |
Obinoscopy: @Liverpoolfc
Nice one! You too much smiley.
However you haven't given the answer to the second question: "Why did his heart rate increase when his blood pressure dropped?" |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 7:44am On Jul 09, 2019 |
Liverpoolfc: @Obinoscopy
promethazine is an antihistamine with also anticholinegic activities. Inhibition of the neurotransmitter acetylcholine inhibits parasympathetic activities so, sympathetic activities are exacerbated. That's all. |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 7:43am On Jul 09, 2019 |
Obinoscopy: Guys find below a Case Study on Clinical Pharmacology culled from Katzung:
A teenage boy is seen at the office of a dental surgeon for extraction of an impacted wisdom tooth. He is so nervous
that the dentist decides to administer a sedative to calm the boy. After intravenous administration of the sedative (promethazine), the boy relaxes and the extraction is accomplished with no complications. However, when the boy stands up from the dental chair, he turns very pale and faints.
Lying on the floor, he rapidly regains consciousness, but has a rapid heart rate of 120 bpm and a blood pressure of only 110/70 mm Hg. When he sits up, his heart rate increases to 140 bpm, his pressure drops to 80/40 mm Hg, and he complains of faintness. He is helped to a couch in the reception area, where he rests for 30 minutes. At the end of this time the boy is able to sit up without symptoms and, after an additional
15 minutes, is able to stand without difficulty. What autonomic effects might promethazine have that would explain the patient’s signs and symptoms? Why did his heart rate increase when his blood pressure dropped? |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 7:41am On Jul 09, 2019 |
1k001: Oral anticoagulants
Warfarin (coumadin) VKA
Indications
Prophylaxis of systemic embolism in patients with rheumatic heart disease and atrial fibrillation.
• Prophylaxis after insertion of prosthetic heart valves.
• Prophylaxis of venous thrombosis and pulmonary embolism and for use in the treatment of these
conditions to prevent their extension.
Pharmacology
Vitamin K antagonists. It acts by inhibiting the formation of active vitamin K dependent clotting
factors II, VII, IX and X.
Interactions
Other anticoagulants/ antiplatelets – increased bleeding risk
Metabolized by cytochrome P450 enzymes – 1A2, 3A4, 2C9 thus medications that induce
(phenytoin, rifampicin) or inhibit (cimetidine, ketoconazole) these enzymes will interact.
Broad spectrum antibiotics that reduce vit K producing gut flora e.g clarithromycin
Others such as alcohol, herbal preparations, grapefruit juice
Notes
Has narrow therapeutic window so needs regular monitoring with INR
Is pro-thrombotic when first initiated as it inhibits protein C & S before the clotting
factors. May need alternative anticoagulant until therapeutic INR reached
Clinical risk scores such as ‘CHADSVASC’ in a.fib and ‘HASBLED’ are useful in
deciding risk and benefit of initiating it
May be reversed by ingestion of Vitamin K
NNT – 1 in 25 to prevent stroke
1 in 42 to prevent death from any cause
Dabigatran – Direct thrombin inhibitor
Indication
Initially was only for thromboprophylaxis in hip and knee replacement but has now
been extended to include stroke and systemic embolism prevention in non valvular atrial fibrillation (AF) thanks to the RE-LY study
Pharmacology
Is a direct thrombin inhibitor. Thrombin enables conversion of fibrinogen to fibrin
in coagulation cascade, its inhibition results in reduced thrombus formation. Also
inhibits thrombin induced platelet aggregation
Interactions
Other antiplatelets/ anticoagulants – increased bleeding risk
is a substrate for the P glycoprotein transporter so may interact with inhibitors (Amiodarone,
verapamil, clarithromycin or inducers (Rifampicin, carbamazepine, phenytoin
Increased bleeding risk with SSRI and SNRI (Pgp substrates)
Notes
Dose is usually 220mg in 2 daily divided doses i.e 110mg bd
Reduced dosing in renal impairment and elderly patients
No need for routine monitoring,
APTT may help estimate extent of anticoagulation but not totally reliable.
If any HB drop during treatment, bleeding source should be identified
No reversal agent is available although I hear research on a specific antibody is at an advanced
stage. It will no doubt be bloody expensive!
Rivaroxaban – Direct Xa inhibitor
Indication: similar to Dabigatran was initially for Prevention of (VTE) in adult patients
undergoing elective hip or knee replacement surgery. License has since been extended to use in non valvular AF. See ROCKET-AF trial
Mode of action – Is a direct factor Xa inhibitor, it thus interrupts the intrinsic and extrinsic
pathway of the coagulation cascade
Interactions
Increased bleeding risk with other anticoagulants/ antiplatelets
Metabolized by CYP 3A4 and PGP. May interact with inhibitors and inducers of both
Notes
Use with caution in renal impairment
No specific antidote
Similar drug apixiban has shown less bleeding risk compared with other oral anticoagulants in
recent studies
Short summary, by no means exhaustive. Comments or questions welcome |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 7:39am On Jul 09, 2019 |
Liverpoolfc: The autonomic nervous system Is ''automatic'' devoid of voluntary control. It control the activities of the viscerals such as the heart, kidney, blood vessels etc. It is also known as the vegetative system. The autonomic nervous system is subdivided into two namely the sympathetic and parasympathetic. It should homever be noted that some text books include enteric as the third division of ANS.
The sympathetic division uses norepinephrine as its neurotransmitter while the parasympathetic divison uses acetylcholine as its neurotransmitter.
To understand their various activities, ask yourself this question, '' what will happen now if I hear a gun shot in the next room? Guy 1) your heartrate will increase, ur bp will be high, you pupil will dilate to see better, your joystick will relax even if it was ready for action, the bronchioles will dilate etc. All the above named activities are sympathetic and exogenous agent that helps bring about /facilitate sypathetic activities are said to be sympathetomimetic agent.
The parasympathetic nervous system often known as Rest and Digest system is set into play when a guy sees a chick and he is in happy mood. E.g his joystick will rise(Attention) his pupil will constrict so he will see less,all git activities will increase, heart rate will decrease etc exogenous agent that help to facilitate parasympathetic nervous system are know as parasympathomimetic agent.
Anatomically, the sympathetic nervous system is said to be thoraco lumber in origin while that of parasympathec nervous system is said to be craniosacral in origin.
This is not a presentation yet just a brief discussion on ANS, if there is lite in my crib tonight, I will present the pharmacology part. |
| Education › Re: Clinical Pharmacology Discussion Thread by Obinoscopy(op): 7:36am On Jul 09, 2019 |
alstacs: Obinoscopy:
Quinine is very safe in pregnancy. Its the only drug that I know to have an established safety profile during the first trimester. However its cinchonic side-effects on the mother is the main reason why most patients don't like taking it. Most prefer the Artemisinin Combination Therapy Regimen (its still okay to take this in the first trimester if its benefit outweighs its risk) or even Chloroquine (also safe during 1st trimester). I've never gotten a complaint regarding the incidence of womanly Bleeding during pregnancy due to Quinine usage from either the doctors, nurses or patients in the hospital I worked in. However, I think its left for other clinicians to give us their own experience in this matter.
Regards. Quinine was actually classified as unsafe in pregnancy in the past and the WHO and National guidelines on malaria treatment that proposed quinine as the drug of choice in early pregnancy was challenged by many. it is however important to note the drug had been reclassified.
Safety in studies is one thing, on the other hand however is clinical tolerability and acceptability to the patient. With the advent of patient centred care, consideration of the latter is very important. therefore, quinine is pharmacologically safe but not tolerable or acceptable to most patients.
Talking about our personal experiences to establish side effects and facts may not be the best as we may be wrong in our observations. please refer to evidence based medicine and our personal experiences may not carry any weight at all.
by the way, this is a nice thread if the delinquents don't invade as usual. I wish to observe from the background.....so no induction for me. |
